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This research and the OPC was funded by Fundacion Madrilena de Hematologia y Hemoterapia and Fundacion Leucemia y Linfoma and hosted by Asociacion Madrilena de Hematologia y Hemoterapia (AMHH).

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COVID-19 Severity and Survival over Time in Patients with Hematologic Malignancies: A Population-Based Registry Study

Publicado en:Cancers. 15 (5): 1497- - 2023-03-01 15(5), DOI: 10.3390/cancers15051497

Autores: Martinez-Lopez, Joaquin; De la Cruz, Javier; Gil-Manso, Rodrigo; Alegre, Adrian; Ortiz, Javier; Llamas, Pilar; Martinez, Yolanda; Hernandez-Rivas, Jose-Angel; Gonzalez-Gascon, Isabel; Benavente, Celina; Estival Monteliu, Pablo; Jimenez-Yuste, Victor; Canales, Miguel; Bastos, Mariana; Kwon, Mi; Valenciano, Susana; Callejas-Charavia, Marta; Lopez-Jimenez, Javier; Herrera, Pilar; Duarte, Rafael; Nunez Martin-Buitrago, Lucia; Sanchez Godoy, Pedro; Jacome Yerovi, Cristina; Martinez-Barranco, Pilar; Garcia Roa, Maria; Escolano Escobar, Cristian; Matilla, Arturo; Rosado Sierra, Belen; Concepcion Alaez-Uson, Maria; Quiroz-Cervantes, Keina; Martinez-Chamorro, Carmen; Perez-Oteyza, Jaime; Martos-Martinez, Rafael; Herraez, Regina; Gonzalez-Santillana, Clara; Francisco Del Campo, Juan; Alonso, Arancha; de la Fuente, Adolfo; Pascual, Adriana; Bustelos-Rodriguez, Rosalia; Sebrango, Ana; Ruiz, Elena; Alexis Marcheco-Pupo, Eriel; Grande, Carlos; Cedillo, Angel; Lumbreras, Carlos; Arroyo Barea, Andres; Casas-Rojo, Jose Manuel; Calbacho, Maria; Luis Diez-Martin, Jose; Garcia-Suarez, Julio

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Simple Summary There are contradictory data about coronavirus disease (COVID-19) in patients with hematological malignancies. In this population-based study we evaluated severity and survival of unvaccinated patients with hematological malignancies (HM) and COVID-19 in the Madrid region, Spain, between early February 2020 and February 2021. Also, a comparison was made with non-cancer patients from the SEMI-COVID registry and post COVID-19 conditions were evaluated. Overall, 30-day mortality was 32.7%, with higher mortality among certain groups of patients (aged >= 60 years, presence of >= 3 comorbidities, diagnosis of AML/ALL, treatment with conventional chemotherapy within 30 days of COVID-19 diagnosis, recipients of systemic corticosteroids as COVID-19 therapy). Mortality rates were similar between earlier and later phases of the pandemic, not paralleling the reduction of mortality in non-cancer patients. Up to 27.3% patients had a post COVID-19 condition. These findings will be useful to understand COVID-19 morbidity and mortality in unvaccinated patients diagnosed with HM. Mortality rates for COVID-19 have declined over time in the general population, but data in patients with hematologic malignancies are contradictory. We identified independent prognostic factors for COVID-19 severity and survival in unvaccinated patients with hematologic malignancies, compared mortality rates over time and versus non-cancer inpatients, and investigated post COVID-19 condition. Data were analyzed from 1166 consecutive, eligible patients with hematologic malignancies from the population-based HEMATO-MADRID registry, Spain, with COVID-19 prior to vaccination roll-out, stratified into early (February-June 2020; n = 769 (66%)) and later (July 2020-February 2021; n = 397 (34%)) cohorts. Propensity-score matched non-cancer patients were identified from the SEMI-COVID registry. A lower proportion of patients were hospitalized in the later waves (54.2%) compared to the earlier (88.6%), OR 0.15, 95%CI 0.11-0.20. The proportion of hospitalized patients admitted to the ICU was higher in the later cohort (103/215, 47.9%) compared with the early cohort (170/681, 25.0%, 2.77; 2.01-3.82). The reduced 30-day mortality between early and later cohorts of non-cancer inpatients (29.6% vs. 12.6%, OR 0.34; 0.22-0.53) was not paralleled in inpatients with hematologic malignancies (32.3% vs. 34.8%, OR 1.12; 0.81-1.5). Among evaluable patients, 27.3% had post COVID-19 condition. These findings will help inform evidence-based preventive and therapeutic strategies for patients with hematologic malignancies and COVID-19 diagnosis.

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